Top Pap smear Questions

1-When should Pap screening begin? Age 21 y/o,3yrs after first intercourse

2-What are screening methods&intervals(for Pap &HPV)? Cytology : 1-Conventional(20%FN ) : 2 - Liquid-based Surepath Thinprep Focal point -HPV co-test(cytology+HPV test) -primary hrHPV testing(16+18+pool results of 12 other hrHPV) -Every 3yrs(conventional or liquid-based)

3-When can women C/C Pap smear? Aged> 65 with adequate negative prior screening & no history of CIN2 or higher within the last 20 yrs

4-What are RF for HPV INFXN? A-Multiple sex partners B-High-risk partners C-Cigarette smoking D- Immunodificiency E-HX of STD F- Early age at first intercourse

5- What are the three HPV vaccines? A- Gardasil (quadravalent )for protection against HPV 16,18,6,11 B- Cervarix (bivalent) for protection against HPV 16,18 C- Gardasil 9(9-valent)for protection against HPV 16,18,6,11,31,33,45,52,58

6- What are the 6 components of the Pap smear ? A- Description (Conventional or liquid – based ) B- Description of Adequacy ( Satisfactory ) C- General Category (negative or positive for epithelial cell Abnormality ) D- Interpretation / Result E- Description of ancillary testing (hr HPV Test ) F- Educational notes & Suggestion (optional)

7- What are some non-neoplastic Pap smear findings?? Yes. A-INFXN: Trichomonas, fungi (Candida), BV, HSV 2,non- specific B- Reactive: Inflammation, radiation, IUD C- Atrophic change

8- Do women who have been vaccinated against HPV still need to be screened for cervical cancer? Yes. Current HPV vaccines do not protect against all HPV types that cause cervical cancer

9- Can HPV infections be prevented? A- Not sexually active B- Vaccine C- Condom

10- What are the aims of Pap smear? A-Detection of precancerous cervical lesions B- Detection of inflammatory & infectious cervical lesions ( especially HPV) C-Detection of cervical cancer D- Hormonal evaluation E- Follow up of cervical cancer

11- When is the best Time to get a Pap smear in a month? A- Mid-cycle or two weeks after the last LMP B- 12 weeks or 3 months postpartum

12-How to prepare for a Pap Test? Avoid intercourse,Douching & vaginal inserts for 24 to 48 h

13-What is the relationship between HPV & cervical cancer ? A- It is more important than association between cigarette smoking & lung cancer B- Extremely common ( most common viral infection of the reproductive tract) C- Over 100 types of HPV, At least 15 HR type D- HPV 16, 18 cause 70% of cervical cancer & precancerous cervical lesions E- Skin – to – skin genital contact is a well-recognized mode of Transmission

14-Does having HPV or abnormal cervical cells affect chances of getting pregnant or have healthy babies? A- No B- But if one needs treatment, it could affect fertility or carrying a baby to term

15- Is there any test for men to find out if they have HPV? A – No B- Genital warts

16- Do one need to check LR HPV Test ? A- No disease progression B- No change Treatment

17- Do need to continue Pap test in patients with history of endometrial caner? - No

18- Who should not have the Pap Test? A- <21 Y/O B- No sexual activity C- Had total hysterectomy for non-cancer lesions D- Aged >65 years with adequate screening history E- Dialysis Patients with limited life expectancies without sign & symptom (ASN)

19- What are the most important references for Pap Test? A- American Society for Clinical Pathology (ASCP) B- American Cancer Society (ACS) C- American Society for Colposcopy & Cervical Pathology (ASCCP) D- U.S. Preventive Services Task Force (USPSTF) E- American College of Obstetricians &Gynecologists (ACOG) F- National Cancer Institute (NIH) G- Society of Gynecologic oncology (SGO)